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Critical Illness – Claimant Statement (to be completed for all CI Illnesses)
Coverage Details
Description
Claimant Statement for Critical Illness Diagnosis (to be completed for all CI illnesses)
Applicable for
Member / Spouse
Related Benefits
Submit your form online:
Step 1
Download, print and fill out the form.
Download Form Step 2
Upload the form using our online submission form.
Upload NowSubmit by mail:
LiUNAcare Local 183
200 Labourers Way
Vaughan, ON, L4H 5H9
Suite 2100
